PB2336: TREATMENT PATTERN AND OUTCOME IN SYSTEMIC T AND NK CELL LYMPHOMA: AN ASIAN SINGLE CENTER EXPERIENCE
Authors: Meng-Ta Sung, Ken-Hong Lim
Journal: HemaSphere (2023)

Topic: 19. Aggressive Non-Hodgkin lymphoma - Clinical Background: T and NK cell lymphoma is a heterogenous group of lymphoid neoplasms. The outcome is generally worse than B-cell lymphoma. The treatment patterns are different in specific subtypes. In Asia, T and NK cell lymphoma is more prevalent but the treatment approaches are varied. More real-world evidence are highly required for understanding the disease. Aims: To evaluate the patient characteristics and treatment outcomes of T and NK cell lymphoma in an Asian referral medical center. Methods: We retrospectively recruit the lymphoma patients from our electronic medical record database from 2008 to 2017. Patient characteristics including age, sex, subtypes, performance status, stage, international prognostic index (IPI), baseline hemogram, chemotherapy regimen, radiation, transplantation, treatment response, relapse and survival are collected. Kaplan-Meier method was used to estimate survival. Multi-variate analysis was performed to evaluate the prognostic factors. Analysis was done by MedCalc version 19.8 (MedCal Software LTD). Results: From 2008 to 2017, 83 patients were diagnosed of T and NK cell lymphoma. 13 patients were excluded due to lack of detailed data. 70 patients were included for further analysis. The median age of patients were 54.5 years old. 45 patients (64.2%) were male. The distribution of the subtypes was heterogenous: PTCL, NOS 18 patients (25.7%), ALCL 5 patients (7.1%), AITL 8 patients (11.4%), ENTCL 24 patients (34.3%), T-LBL 5 patients (7.1%), other subtypes 8 patients (11.4), GI lymphoma 2 patients (2.9%). ECOG was 0- 1 in 48 patients (80%). The stage and IPI score were generally equally distributed. For treatment pattern, 22 patients (31.4%) received CHOP-like regimen; 12 patients (17.1%) received cisplatin-based regimen (mainly ENKTL); 22 patients (31.4%) received other regimens. 14 patients (20%) did not receive any treatment. Radiation was performed in 18 patients (25.7%). 14 patients (20%) with ENKTL underwent chemoradiation. No patient underwent autologous stem cell transplantation in our cohort. Complete responses were achieved in 29 patients (41.4%), partial responses in 7 patients (%). The median overall survival was 29.9 months (CI: 15.8 to 104.8). The 5-year survival rate was 46.1%. The median overall survival rate by the subtypes were as follows: PTCL, NOS, 55.2 months (8.0- 55.2); ALCL, not reach; AITL, 16.3 months (0.1- 104.8); ENKTL, 10.5 months (4.7- 27.6). Patients who were responded to the frontline therapy had better outcomes. Median OS were not reached in the CR and PR group, compared with 9.7 months in the SD/PD group and 0.37 months in the group which was not evaluable. Summary/Conclusion: In our cohort, we demonstrate that the heterogenous subtypes and treatment patterns of T and NK cell lymphoma. The overall survival was not satisfactory compared with B-cell lymphoma. ALCL had the best outcome. ENKTL was mainly treated with chemoradiation, but the survival was still dismal. Response to the initial treatment inferred the better survival. Further studies are mandatory for better classification and novel therapies to improve the outcome of T and NK cell lymphoma.Keywords: T cell lymphoma, Lymphoma therapy, Malignant lymphoma